1. Localization of Activation Origin on Patient-Specific Epicardial Surface by Empirical Bayesian Method.
- Author
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Zhou S, Sapp JL, Dawoud F, and Horacek BM
- Subjects
- Adult, Aged, Algorithms, Bayes Theorem, Body Surface Potential Mapping, Humans, Male, Patient-Specific Modeling, Tachycardia, Ventricular diagnostic imaging, Tachycardia, Ventricular physiopathology, Tachycardia, Ventricular surgery, Cardiac Imaging Techniques methods, Catheter Ablation methods, Electrocardiography methods, Pericardium diagnostic imaging, Pericardium physiology
- Abstract
Objective: Ablation treatment of ventricular arrhythmias can be facilitated by pre-procedure planning aided by electrocardiographic inverse solution, which can help to localize the origin of arrhythmia. Our aim was to improve localization accuracy of the inverse solution by using a novel Bayesian approach., Methods: The inverse problem of electrocardiography was solved by reconstructing epicardial potentials from 120 body-surface electrocardiograms and from patient-specific geometry of the heart and torso for four patients suffering from scar-related ventricular tachycardia who underwent epicardial catheter mapping, which included pace-mapping. Simulations using dipole sources in patient-specific geometry were also performed. The proposed method, using dynamic spatio-temporal a priori constraints of the solution, was compared with classical Tikhonov methods based on fixed constraints., Results: The mean localization error of the proposed method for all available pacing sites (n=78) was significantly smaller than that achieved by Tikhonov methods; specifically, the localization accuracy for pacing in the normal tissue (n=17) was [Formula: see text] mm (mean ± SD) versus [Formula: see text] mm reported in the previous study using the same clinical data and Tikhonov regularization. Simulation experiments further supported these clinical findings., Conclusion: The promising results of in vivo and in silico experiments presented in this study provide a strong incentive to pursuing further investigation of data-driven Bayesian methods in solving the electrocardiographic inverse problem., Significance: The proposed approach to localizing origin of ventricular activation sequence may have important applications in pre-procedure assessment of arrhythmias and in guiding their ablation treatment.
- Published
- 2019
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